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目的观察静脉溶栓序贯给药法对急性心肌梗塞早期冠脉再通的疗效。方法２０５例ＡＭＩ患者随机分成序贯组（溶栓前肝素－尿激酶－溶栓后肝素）１０７例，和对照组（９８例）。尿激酶溶栓前序贯组先用肝素５０００Ｕ，而对照组只用安慰剂（尿激酶－肝素）。结果序贯组的早期冠脉再通率明显高于对照组，分别为７１．０３％和５２．０４％，Ｐ＜０．０１，前者的ＳＴ段回落和Ｔ波反转也明显快于后者。两组出血并发症相似。结论静脉溶栓序贯给药法明显提高早期冠脉再通率而不增加出血危险性。
Objective To observe the effect of sequential intravenous thrombolytic therapy on acute coronary recanalization after acute myocardial infarction. Methods A total of 205 patients with AMI were randomly divided into sequential group (heparin - urokinase - thrombolytic heparin after thrombolysis) 107 cases and control group (98 cases). Prior to thrombolysis with urokinase, heparin 5000U was used in the sequential group, whereas placebo (urokinase-heparin) was used in the control group. Results The rate of early coronary recanalization in the sequential group was significantly higher than that in the control group (71.03% and 52.04%, P <0.01). The ST segment depression and T wave inversion in the former group were also significantly faster than those in the control group By. Bleeding complications were similar in both groups. Conclusion Intravenous thrombolysis sequential administration significantly improved early coronary recanalization rate without increasing the risk of bleeding.